One of the most pressing needs you may be facing is recovering or supporting the recovery of emotional health and well-being during times of isolation, division, illness, and grief. We have been through a lot, and our physical and emotional recovery is top of mind. liveWELL’s Senior Director, Megan Hammes, interviews campus experts with some important questions as we consider our return to campus and global recovery.

liveWELL: What is the usual emotional fallout that can happen when things settle down after a crisis like we have had with the COVID-19 pandemic?

Barry Schrier response: As we move out of crisis response mode, the impacts of being in crisis can begin to appear.  This crisis is unique as it has gone on for months and continues to have an ambiguous ending.  Community crisis usually happen in a discrete amount of time and then it’s over.  The pandemic has not been this way at all.  As such, many of us will go through an “emergence” process whereby we will emerge from the crisis mode we have been in for 16+ months.  Emergence can mean loss and change (as was the case when we went into lock down) and both of these usually mean distress.  Trust could be a struggle, too, in terms of trusting systems, spaces, contact with others, and so on until familiarity of new patterns settles back in.  Lastly, the pandemic has once again brought a magnifying glass to injustices where people fared inequitably in the pandemic.  Race, ethnicity, sexual orientation, and gender identity have all made significant differences in one’s ability to feel safe, to access resources, have choice in managing work and health, and in chances of getting sick and/or losing someone to COVID.  Emergence will increase reckoning to make good on these injustices.  Feelings of anger and guilt are just a couple ways people will emerge around these matters, but we must not become stalled by this.  Emergence is something we will all make our way through but can take time and experience and patience and grace with ourselves and others will help this process.

Barry Schreier, PhD

Director, University Counseling Service

Professor of Counseling Psychology

Laura Fuller response: When I reflected on this question in the context of my work with children and families, I found several emotion words coming to mind: Uncertainty, Fatigue, Grief, Disconnection, Hyperarousal, Fear, and Guilt. There are others, of course. Many of these are feelings that people experienced from the very start of the pandemic. Now that things are “opening up” these feelings are showing up in different ways and for different reasons.

• Uncertainty- right now people are expressing stress due to uncertainty about many pandemic-related issues. Questions such as, “how safe is it now?” “Should I get a vaccine/wear a mask/go out in public?” and “What will people think if tell them what I really think and feel about this situation?” are common. At times it feels like a minefield with people holding strong opinions and making judgments about others’ healthcare decisions. Parents feel the strong urge to protect their children, but are unsure what that entails. For example, I hear families and professionals discussing some version of the following question: “Is it more damaging to expose children to potential infection, or to keep them away from the things that children need to grow, learn and flourish?” with no single clear answer that is available. All of this uncertainty is stressful.
• Fatigue- almost everyone I know, including friends, family, colleagues, and the children and families I treat at UIHC, talk about how tiring this pandemic has been. It feels like running a marathon where you have no real idea what mile marker you are at. Feelings of exhaustion come in waves for some, while others describe it as persistent. Individuals who report that they are “treading water” describe to me that their weariness manifests as difficulty doing anything “extra” beyond the absolute basics of job, school, food, and shelter. For others, it is a physical or mental lack of energy that is affecting them most or all of the time.
• Grief- of course there is grief about the loss of loved ones during the COVID pandemic, whether directly related to the virus or not. In addition, there is the additional grief surrounding not being able to assemble to mark these passings in the usual ways. A personal example is that in summer 2020 I attended funerals for two of my cousins. One was a Zoom funeral and the other a socially distanced funeral. The Zoom service did allow many people from all over the country to gather safely, but it was different than connecting with people in person. And at the in-person memorial, I felt stress about how to handle all the people wanting to give hugs to me and some of my elderly relatives. The desire to keep myself and my loved ones safe was in conflict with my desire to give and receive comfort through physical proximity. And spending my energy worrying about those things made it harder to do what I was there to do- grieving the loss. As we are entering this new phase of the pandemic, people may continue to grieve things not being “entirely normal” and may also at times realize that they miss some aspects of how things were a year ago, such as having more family time or more time out in nature. However, keep in mind that “more family time” is not something that everyone is quite ready to miss, yet, such as those parents who are still trying to work and school their children from home with little respite, or teens who quite naturally want to be with other adolescents.
• Disconnection- human beings are social creatures. After a year in which almost every aspect of life—work, school, home, recreation, worship, and self-care—has been different than it was in the past, people are feeling disconnected from their usual routines, supports and outlets for stress reduction. Finding ways to reconnect is becoming easier in some situations, but in some cases it is much more difficult.
• Hyperarousal and Fear- some people are finding that their systems have been on “high alert” for over a year and that they are now having a hard time relaxing the vigilance they were exercising when they believed that one small misstep might bring danger to themselves or others. They may experience difficulty relaxing, trouble sleeping, or problems with concentrating or focusing. Figuring out how to let go of some of the safety practices that were adopted during the pandemic is hard because in many cases we don’t know exactly what is or isn’t keeping us safe until something bad happens.
• Guilt- this is one that people don’t talk as much about. There are people who feel guilty about having done or not done certain things during the pandemic, such as exposing loved ones to illness, or not doing more to help friends or family members who are struggling even more than they are. Another type of guilt is the “survivor guilt” people experience when they hear about the huge emotional toll the pandemic took on others, while acknowledging that they are actually doing OK or have come through things relatively unscathed. For some these days, feeling OK can be a source of guilt.

The bottom line is that these feelings are common and normal for the times we are living in. My advice is to be kind to yourselves and others, give it some time, observe your own limits, find ways to connect, practice gratitude, and seek help if needed for yourselves or your family.

Laura L. Fuller, Ph.D., ABPP
Clinical Associate Professor/Licensed Psychologist
Department of Psychiatry
University of Iowa Health Care
200 Hawkins Drive, 2937 JPP
 

liveWELL: What are you the most concerned about as things begin to settle down after the COVID-19 pandemic?

David J. Moser, Ph.D., ABPP-CN response: The pandemic, as unspeakably tragic as it has been, has allowed us to learn so much about disease prevention, vaccine development and rollout, how to be flexible with our family life, work, and schedules, and so many other lessons. I worry, though, that as things get back to normal we will fail to take advantage of a different learning opportunity – specifically the opportunity to better understand healthcare disparities and how to resolve them. The pandemic has been tough on all of us, but not equally so. Research data confirm what many have witnessed with their own eyes – folks from minority, marginalized, and underrepresented groups, in addition to dealing with various forms of chronic discrimination and oppression, have been more likely to contract COVID-19, less likely to have access to adequate health care, and more likely to become seriously ill and die. More simply put, the pandemic has magnified the gaping healthcare disparities that were already so deeply and problematically woven into our society. Bringing these hard facts to light gives us an opportunity to better understand and reduce healthcare disparities, whether they’re related to the pandemic or not. And yet at the same time, spring has sprung, folks are getting vaccinated, mask and gathering rules are becoming less restrictive, and so many among us are celebrating an impending return to normal. The problem with that is that normal is only as good as normal actually was, and for so many in our society, normal was unfair, unjust, and inequitable. The fact that the pandemic is finally coming under better control is obviously reason to celebrate, but as we do that, I hope we can work toward a better normal rather than returning to the one we had.

David J. Moser, Ph.D., ABPP-CN

Board Certified Neuropsychologist & Professor of Psychiatry

Vice Chair – Psychiatry Faculty Affairs & Development

Director of Educational Outreach – Office of Diversity, Equity, & Inclusion

University of Iowa Carver College of Medicine

Maggie Moore, L.I.S.W. response: Although people are excited about vaccinations and the reopening of campus and our community, adjusting will likely take time.  Our transition back to work or school may not necessarily be easy. What we know is that everyone’s experience with the pandemic is different, and it’s very important as we reemerge, to not compare our experiences to others.  The effects of the COVID-19 pandemic on the workplace will likely be felt for some time. Some of this will be due to returning to work with a hybrid schedule or maybe because our work has changed or we haven’t left the workplace. And some of the stress of the return is the mental and emotional toll the pandemic has taken on us, as many of us may have spent the past year living in fear, isolation and sadness.  And some of the mental health issues that arose during the pandemic may not dissipate and could continue to affect interactions with others and our performance.  According to data from the APA, there are extensive markers of unhealthy coping during the pandemic—including disrupted sleep, increased alcohol consumption and low physical activity with some 61% reporting unintended weight gain or loss. It will be important to care for ourselves, physically and emotionally while we move forward. We may wish to revisit our purpose at work, at home, socially or in the community and we may want to build our resilience by processing our thoughts, reaching out for help, connecting with people and reminding that it will take time. Practice grace and go easy on yourself if you are frustrated that you may not feel the way that you did before the pandemic.  We are all affected.  And try to catch yourself when you may be holding yourself to unreasonable standards. Think about what strength it takes to keep going.  And finally, know it is okay to ask for help. How other folks may cope isn’t relevant to your journey. If you feel like you need (or want) help, it’s important to get that as soon as you can. 

Maggie Moore, L.I.S.W.

Director

UI Employee Assistance Program

A Unit of Human Resources

University of Iowa

liveWELL: If I am concerned about the wellbeing of my students or my staff, what are the best things to do to offer support?

Nikki Hodous, M.A. response: In a 2019 article in the Chronicle of Higher Education, the a study of nearly 7,000 student on 34 campuses shared the same conclusion: “Students’ perceptions of the degree to which the institution was supportive of their academic, personal, and social needs were the most powerful predictor … of increased academic competence.”  In short, the more students believe that they belong, the better they do academically. (Kirp, 2019) This view of a student’s overall health and well-being is crucial to their success and the role we play as faculty and staff is vital to supporting and encouraging it.

I often hear from faculty and staff that they are unsure what to do if they believe a student is in distress and they don’t want to make a mistake. The only mistake would be to not say anything if you are worried. The below steps can help provide a guide for supporting a student you are concerned about (or anyone you interact with, including colleagues.)

1. Recognize: Noticing concerns requires us to be engaged and aware. Some signs of distress may be obvious, like disclosing significant life changes (ex. the death of a loved one.) Others may not be as clear, including: changes in their usual demeanor, lack of energy, or withdrawal from activities or commitments. This requires us to be aware of our students early and often in order to notice such changes.

2. Respond: When you do notice concerns, it’s important to respond to them. Find an appropriate time and place to talk privately. If you’re unsure where to start the conversation, share what you have noticed. For example, “Sam, you are usually a very engaged student that participates in class and performs well. I’ve noticed in the past few weeks that you have missed a lot of class and haven’t turned in any assignments. This doesn’t seem like you and I’m concerned. What’s going on?” With this, you’ve shared what you are noticing, expressed that you are concerned, and are seeking to learn more. Even if they choose to not share, you’ve demonstrated you care and are someone willing to assist them.

3. Refer: Some of the stressors a student discloses may be things you can assist with, such as changing their work shifts or making adjustments to deadline dates. However, many of the concerns may be outside of your role and would best be addressed by others with specialty. That’s okay! We have a campus full of expertise that can help. If you know of specific offices, feel free to share their information and encourage the student to utilize them. If you’re unsure where to start or the student seems to have a lot of concerns many aspects of their life, you can always contact or make a referral Student Care & Assistance (dos.uiowa.edu/assistance.) We can consult with you and help determine next steps, which can include our office directly outreaching to the student.

4. Re-engage: Make a plan to check back in with the student. This can be as simple as an email to see if they were able to connect with the resource(s) you shared, inquiring how they are doing, and expressing your belief in their ability to overcome or navigate their concerns. If you notice the concerns are not improving over time, asking to meet again with the student would be appropriate, as well as consulting with Student Care & Assistance.

As we prepare for fall semester, there are many things we can consider implementing to encourage the health and wellbeing of our students from the onset. Some things to consider:

1. Critically examining our work: What are ways we can shift our approaches from lessons learned during the pandemic to better support student success? We cannot simply revert back to our 2019 ways and expect students to perform as before. Experts are predicting the end of the pandemic and a return to more “regular” functions will bring with it a mental health crisis. As a campus, we are preparing and making plans for fall but we each have a role to play. What flexibility, different methods of delivery, and changes should be implemented moving forward? This doesn’t remove the need for basic expectations in the classroom or work setting; rather, this is a call to really consider what our expectations actually need to be and how to implement them equitably.
2. What do we espouse, how do we do it, and how often do we share it? Take the time to reflect what matters to you and the way you work with students. If you believe that all students’ health and well-being matters (and I hope you do!), how are you verbalizing and demonstrating this? How are you intentionally integrating this throughout the semester and not simply as a message during the first day of class/work? When you are meeting with a student individually, will you simply seek to answer their question or will you go beyond to ask more about their experiences and how they are doing in other areas of their life?
3. Make a commitment and a plan: What actions will you take that show congruence with your values and student success? Some ways of doing this include:
   1. Adding information to your syllabus and adapting your class. You can find already prepared language for issues such as food insecurity/basic needs or mental health concerns in the recommended syllabi elements from the Office of the Provost: https://provost.uiowa.edu/teaching-resources/course-syllabi-information. The Office of Teaching, Learning, and Technology will facilitate events throughout summer, has created resources, and can consult one-on-one to assist with this. Some topics include: leveraging inclusive virtual strategies in person, enhancing clarity and transparency in coursework, trauma informed teaching strategies, and more. (https://teach.its.uiowa.edu/news/looking-forward-fall)
   2. Committing to intentional reminders/check-ins with students. How do you share campus resources to support students throughout the semester? Could you take 2 minutes out of class or post a reminder to the ICON periodically? When working with student employees, how are you interacting with them, asking about their lives, and making meaning of their work? The Division of Student Life seeks to accomplish this through guided reflections from the program, Iowa GROW (https://studentlife.uiowa.edu/initiatives/iowa-grow%C2%AE/).
   3. Identify ways to make sure individuals from all identities, especially those underrepresented, are welcomed into your environment through representation and mattering. Having a sense of belonging is crucial to well-being and engagement; being in a classroom or work environment where you are welcomed and your experiences and values are actively present, integrated by supervisors and instructors, and respected is essential. The Diversity Resources unit in the Division of Diversity, Equity, and Inclusion (https://diversity.uiowa.edu/division/diversity-resources) is a great place to start for consultation, trainings, and resources to assist with this. 

Nikki Hodous, M.A. (she/her/hers)
Director, Student Care & Assistance, Office of the Dean of Students

For more resources on how to care for yourself while also caring for students and colleagues, visit: MentalHealth.Uiowa.edu

This article originally appeared in the liveWELL 2021 Summer Employee Well-Being Newsletter.